Trends From the Trenches - Are the FUGS — Fear, Uncertainty, Greed—Getting You Down?
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HEALTHCARE INNOVATION: TRENDS FROM THE TRENCHES Are the FUGs—Fear, Uncertainty, Greed—Getting you Down? Webinar #1
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Transcript of Trends From the Trenches - Are the FUGS — Fear, Uncertainty, Greed—Getting You Down?
HEALTHCARE INNOVATION: TRENDS FROM THE TRENCHES
Are the FUGs—Fear, Uncertainty, Greed—Getting you Down?Webinar #1
Our Presenters
Andrea J. Simon PhDCorporate Anthropologist
President Simon Associates Management Consultants
Kriss Barlow RN, MBA Principal, Barlow/McCarthy
Healthcare Innovation: Trends from the Trenches
Help you better “see, feel and think” about how to respond to these changing times, and actually move your organization to “do” innovation.
Webinar
Share what we see happening in the “trenches.” Provide concepts and tools that might help you
“innovate.” Open it up to questions and discussion so we can
hear what you are seeing in your “trenches.”
Presenter
Presentation Notes
Perspective on how healthcare clients are dealing with the pain of change and are trying to develop new solutions in response to the changing healthcare environment. I want to share with you an approach that works well to help convert ideas into effective change or innovative solutions. Kriss Barlow is going to share with you what she sees happening in the field that support the effectiveness of this model.
Changing Times, Means Adaptation5
It isn’t the Strongest or the Smartest that SurviveIt is the Most Adaptive!
Healthcare Reform Leading To…
FUGs --Fear, Uncertainty, Greed
From The Field We Are Seeing… The “Pain” of Change. People struggling with new processes and trying to
understand words with new meanings. The are trying to change their cultures. Trying to make wise decisions without “best practices.” Creating new “best practices.” But unsure what will
work. Want to be “Innovative.” Not sure how!
Solution? Healthcare Innovation!
“The Innovations Exchange…goal is to cast a wide net that allows for differences across the health care industry. The Innovations Exchange includes clinical and non clinical activities and tools that vary in degree of novelty, effects on quality or disparities, and level of supporting evidence.” Agency for Healthcare Research and Quality (AHRQ)
Presenter
Presentation Notes
AHRQ does not want to put too tight a frame around this term. Innovation can mean different things to different people, depending on sector as well as organizational and other contextual factors. An activity or policy that is standard practice in one health care system or setting may be cutting-edge for another.
Innovation! Hot Topic Or Cliché?9
Based on Lexis-Nexis research: Between 1970 and 1980, there were exactly 55 articles that mentioned the
term. Between 1980 and 1990– 993 articles. Between 1990 and 2000 -- 3,575 articles And from 2000 to 2007 -- 4,583.( Scott Berkun’s Blog, September 2009)
Search of annual and quarterly reports filed with SEC shows companies mentioned some form of “innovation” 33,528 times—>64% from five years ago.
Amazon in a 90 day period had 225 new books with Innovation in the title.
Presenter
Presentation Notes
A search of annual and quarterly reports filed with the Securities and Exchange Commission shows companies mentioned some form of the word "innovation" 33,528 times last year, which was a 64% increase from five years before that
What Level of Innovation
Maybe, Business Model Innovation
Or, The Spaghetti Approach
Throw a lot up and see what sticks.
Leads You To…
Wonder where do the best ideas come from? How can we reduce the risk and make the right
choices? Not get stalled by too many choices–
“The Paradox of Choice.”
Where Do Innovative Ideas Come From?
Not where you imagine
Which Means that…
We need to tap into those Employees, Doctors, Partners, Customers to find new ideas and innovate effectively?
We need a way to really move our organization forward in the right direction--Innovatively?
Trends From The Trenches
Presenter
Presentation Notes
Why an anthropologist? How can we see things that you do every day that you cannot see yourselves? Our job is to help you see, feel and think in new ways so you can change.
Trends In The Trenches: Vendor Challenge Problem: A vendor who provides outsourced services to healthcare
organizations found that their old line of business services was changing—mostly because their clients were changing.
Solution: Their entire leadership team spent a week digging deep into their ideas through Innovation Gym. They emerged with a business model redesign that was transformative in how they were going to approach their “job” to be done for the evolving clients they serve. And, they were going to engage the clients in the creative process--innovatively.
Innovation: Next challenge is how to put the ideas into action. All about Business Model Innovation!
Another Story: Healthcare System Problem: Changing system meant changing brand relevance. Newly
acquired physicians meant a new story for the brand.
Solutions: Engaged dozens of their associates and physicians in Innovation Games to get them to build their unique “brand” of “how” they deliver their services.
Result: A powerful strategy for re-branding and for internal brand development.
Challenge Now: How to take the ideas and turn them into action. Incremental Innovation. What came from them was quite exciting for them.
And Another: Physician Confusion Problem: Physicians unclear how to become more efficient and quality
focused while they are still FFS paid. What does value-based payments really mean?
“How do I treat that patient—as an episode? A CPT2 code? A chronically ill patient.”
Solutions: Practice Manager is trying to innovatively change their practice behaviors together with them.
Innovation Challenge: This is behavior modification at its best and its most challenging. Almost “Transformational Innovation.”
Finally, Patients and Consumers Problem: “What’s Happening? To Me?”
Used Serious Play to engage them in a process of idea generation and prototyping.
What’s In It for Them: Told us a lot about their ideas about “ Healthcare Innovation.”
Presenter
Presentation Notes
Don’t trust the doctors. Don’t know why they go to an urgi-center to get Tylenol and pay more for it. Rather ask their friend the nurse what to do. Have large deductibles and aren’t going to spend it on their doctor—over the counter will do.
They Were..
Confused CynicalNot Trusting
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Presentation Notes
Cynicism Don’t trust the doctors. Don’t know why they go to an urgent care center to get Tylenol and pay more for it. Rather ask their friend the nurse what to do. Have large deductibles and aren’t going to spend it on their doctor—over-the-counter will do.
What They Wanted?
“Innovations” that were really going to work—for Me? Engagement—include me in the process, please. Simple and easy solutions. Save me money and time.
Trust: Don’t know who to trust any more. Want a system that works: “Ducks all lined up in a row.” Of course, “Care and Caring” for me—this is not about you.
Brain hates change!
Why Is This So Hard?
Why Is Change Such Pain?Brain hates change—literally!
Power Of Habits
While we love to think that we are full of “free will”
We are product of well-honed habits.
Presenter
Presentation Notes
Highly efficient. Very effective. Not easy to change
Comfort Of The Herd--Culture
Presenter
Presentation Notes
We are herd animals. Most comfortable with others like ourselves. Bring in change agents—lonely lives on the outside of the community. We like our position in the herd—know who the leaders are—real and opinion. Life is pretty cool. everyday is like the rest. GO home happy and comfortable.
Perception Is Reality
By the time you are 30 you have a well structured perceptual “mind map.”
Sorts reality to affirm what your “mind map” sees.
But, Brains And Culture Can Change
Our brains have plasticity and you can learn new behaviors and adapt to changing times.
Can adapt culture--values, beliefs and behaviors-- to break away from the herd.
But it takes a rigorous process. Brain needs a hand.
How to make it happen!
6 Steps To Innovation And Change
To Kill The FUGs
If we are going to tackle the FUGs in your organization—you will need to change how you are trying to Innovate.
Focus, Concentration, Integration
“Over-Determine” Success
Need to combine multiple influences in “over-determining” the success of your innovations.
Exceptional research leading to an award- winning process for change—VitalSmarts®.
Presenter
Presentation Notes
Instead of looking for the minimum it will take the combine a critical mass of influence strategies to move people, even themselves, in new directions.
Must Have An Integrated Process Found that those executives that focused on 4+ of the
cultural elements had great results changing their organizations and introducing new ways to get things done—innovatively.
Yet--Only 5% of those surveyed actually did focus on 4+ things.
The rest tried one or two or even three but missed the mark.
Presenter
Presentation Notes
We have learned from the neurosciences and anthropology that
The Process Of Influence And Innovation
MOTIVATION ABILITYPERSONAL 1. Make the Undesirable
Desirable2. Overinvest in skill
buildingSOCIAL 3. Harness peer pressure 4. Create social support
STRUCTURAL 5. Align rewards and assure accountability
6. Change the environment
Grenny, Maxfied, Shimberg, “How to Have Influence” MIT Sloan Management Review, Fall, 2008
Presenter
Presentation Notes
Motivation and ability are the foundation of our six-source model. We then subdivide these domains into three distinct categories: personal, social, and structural, which in turn reflect separate and highly developed bodies of literature: psychology, sociology, and organizational theory. The first two domains, Personal Motivation and Ability, relate to sources of influence within an individual (motives and abilities) that determine their behavioral choices. The next two, Social Motivation and Ability, relate to how other people affect an individual’s choices. The final two, Structural Motivation and Ability, encompass the role of nonhuman factors, such as compensation Area to start is about the Individual, Personal. The horizontal axis is divided into two major areas: Motivation Factor and an Ability Factor. Think about these as highly interconnected and you can get on your way. Think of them as separate and you are going to stay stalled.
1. Make The Undesirable Desirable
Change is Pain, but… “The key to personal motivation
is to help people see the true implications of their actions and choices by connecting the new behaviors to deeply held values.”
“How to 10X Your Influence” Joseph Grenny, David Maxfield, Andrew Shimberg
Presenter
Presentation Notes
Mission and Values inspire them. If you are going to become a more innovative culture you are going to have to think about how to change your core values and beliefs to reflect that. The tendency is to stay fixed on what was—but then how can you change? Become more innovative and still deliver on the mission and values? Perhaps you can, but make sure you understand both how to inspire your individuals and yet encourage them to move in new directions.
2. Ability: Follow With The Skills
Overinvest in skill building. Research shows us that the most
effective innovations and transformations involve deep effective skill development.
And, changing the skills requires practice and rehearsal time—like a theatrical performance.
Presenter
Presentation Notes
Ability: Can they do what you are asking them? Overinvesting in Skill Building is critically important to ensure that staff can do new things in great ways—again the theater metaphor. They played one role really well but don’t know the new one at all and have had no time to rehearse or be directed or coached. Why should they risk playing it and not doing it right?
3. Motivation: Harness Peer Pressure
Remember we are herd animals. Habits and culture drive behavior far
more than you might imagine. Find ways to get the social leaders to
teach, model and support the innovations.
Presenter
Presentation Notes
We are herd animals. People do things with and for other people. If you are going to change and innovate you must think about this from the group perspective. What are the peer pressure elements that will help or hinder your innovation? How do you get alignment around the new? How will you handle the big fish that don’t want to swim in your new pond and will keep the rest from swimming there as well? Work those opinion leaders
4. Ability: Create Social Support
While harnessing peer pressure is motivational, creating social support is essential or they will want to do things but cannot figure out how to.
Use mentors and/or coaches to build the skills and the innovations.
Create safe ways for people to get the help they need.
5. Motivation: Align Rewards And Assure Accountability
Structural Motivation–Rewards and Recognition--is often what leaders focus on.
Adjust the formal rewards system to make sure people have incentives to adopt new behaviors.
Praise is powerful—more so than criticism.
6. Ability: Change The Environment
Critically important in terms of abilities to get the new job done.
Does the environment enable change? Does it fight innovation?
From work processes to policies, from MIS to facilities, are you really set up to get the job done using the new innovation or business model--not simply pushing it into the old?
Six Things You Must Do (at least 4)
Grenny, Maxfied, Shimberg, “How to Have Influence” MIT Sloan Management Review, Fall, 2008
MOTIVATION ABILITYPERSONAL 1. Make the Undesirable
Desirable2. Overinvest in skill
buildingSOCIAL 3. Harness peer pressure 4. Create social support
STRUCTURAL 5. Align rewards and assure accountability
6. Change the environment
Presenter
Presentation Notes
Area to start is about the Individual, Personal. The horizontal axis is divided into two major areas: Motivation Factor and an Ability Factor. Think about these as highly interconnected and you can get on your way. Think of them as separate and you are going to stay stalled.
Where is it working?Let’s turn to Kriss Barlow’s Discussion
What Is Happening In The Field?
Journey WITH Physicians
Changing values and purpose. Investing in skills. Peer group collaboration. Coaching and support. Financial motivators.
Presenter
Presentation Notes
KB slides begin here Really helpful journey within how our minds work- now a little time to focus on that plus the physician side. Recognize can’t clearly predict – goal then is to navigate, continue to live in current world while working to have the tight tools in place for future state. Doctors are not all the same Reactions to a changing environment will be as different as they are Andi brought out each of these elements, I will address from that vantage point of working with medical staff and med staff leaders. Engagement like a partnership must address these 5 at minimum
Shared Values Discussion
Everyone cares about patients. Can’t do this to doctors, must be with them Discussion enders
“ We know best…” “ Let us help you…” “ We’ve done the legwork…”
Presenter
Presentation Notes
Foundation- we all care, nurse/doctor who cares most attitudes seem to be surfacing again with other players like leaders, insurers and the government. Doctors want to be personally successful but at the end of the day- that means that patients got what they needed too. CONSIDER WORDS Med school vs. business school Understand values Shared language with doctors and health care leaders Recent stat from HealthLeaders- independent doctors will still be majority 3 years from now. How does the organization’s approach affirm alignment with this audience and keep momentum with the 40 some percent in the employed ranks. With population health front and center – again more than half of organization’s said they would be pursuing it- what shape does the model take without both groups of doctors aligned. Conversation must become more real, robust and shared.
Clinical Integration Example
The trouble: silos, turf, assumptions, ownership, belief we know best.
Quality proposition. Physician led. Metrics with goals. Shared risk.
Presenter
Presentation Notes
Comes to light in real life examples- lots of healthcare providers doing great things Share example – Advocate Engagement through governance At table, voting ID ambassadors Quality – shared Conversations Dollars were shared Advanced to shared risk
Skill Investment Create a shared goal.
Topic may start with CI, business strategies, payer dilemma Forced choice Measurement
Process is important. Define Assign Nurture
Presenter
Presentation Notes
Innovation is not a scientific process. Innovation is not a project nor is growth a project Shared goal- target, strategy= niche, use data Many org- leader development, essential piece for Advocate, many systems I work with are SEE IT FROM THE OTHER CHAIR Leaders- business dilemma Independent- personal dilemma Employed, someone else’s dilemma Others govn’t dilemma Shared learning- process is critical
Peer Group
Physicians as influencers. Never happens without buy-in and trust Some specialties are more willing
Leverage field staff relationships. Share examples from the practice environment. Revisit how they were trained, emulate the pattern and
process.
Presenter
Presentation Notes
Consider their station- indep less likely than employed to believe accountable care will benefit their practice according to 2013 physician sentiment index.. But beyond this, they also believe the quality will decline further when compared to their employed counterparts. If you are staging peer groups- consider group origin, trust and influencers. Don’t assume they will share good things Begin to evolve your relationship field staff if you have the right talent/caliber to do this- move to more questions about vision, need and much more dialogue vs. product pitch Message continues to be an important part of our framework for collaboration and engagement Again, it’s not that they won’t assimilate into your style of teaching/learning but first off they have to want to and 2nd that takes more work- think about needs, adapt style and that process of deductive reasoning
Coaching and Support Uncertainty has impacted morale. Hospital is not seen as the savior. Transparency is critical. Consistent communication.
Assess Leverage momentum Multiple methods, multiple times in their language. Don’t rely on others or best practices.
Presenter
Presentation Notes
Once a shared goal is created just make sure the first one goes well. Careful about too much scope, realize they are not totally trusting. Governance is so logical, but make sure you will really share control. Remember they are looking for what is what is wrong not right. Suppose it goes without saying , may need to be more willing to try something new, can not always build on others learning's
Business Strategy Case Learning Ask for needs, then respond. Recognize the intellect. Transparent model. Obligate to actions. Emulate their learning style.
Learning through action Results, proof
Invest, invite experts.
Presenter
Presentation Notes
And one more case example of that. Like many organizations, this one realized that they needed to develop more, better physician talent some years ago. The process has evolved as their Dyad model has matured. The essence of leadership development is #1. Identify the high performers. For my case study organization #2. track the impact #3. Expand the involvement started as doctor only and expanded to other leaders- good sharing, interdisciplinary has worked well Learnings if you are taking this next step Modules/workshops that are important based on survey data- did one on crucial conversations and had 570 participants Other hot topics Emotional intelligence- conflict mgment, business and network development Financial LEAN process People management Team building Challenge with doctor schedules- required evenings Build a standing time frame Get feedback Assess skill transfer and the real ability to learn and communicate
REAL Engagement
Every one wants to be paid. Outcomes is not a hospital thing. Change starts within.
Momentum is contagious It must be fed
Be clear about the goal, remind and reward then take the next step.
Presenter
Presentation Notes
In summary…
What Do We Know?
Presenter
Presentation Notes
Doctors need to be part of our new model Right now there is limited synergy with the 2 groups in many markets Shared goals and vision, hospital has to start this Don’t really know where it is going- hard for a scientist to be uncertain Communication is essential, right words, good plans, Numbers sell in healthcare so use data when available to help with the process Train the leaders- find a clear process to assess, nurture, educate and validate Andi, back to you
Ambiguous times are the most dangerous.
Can you get rid of the FUGs?
Let’s Go Back To Those FUGs
FUGs—Fear, Uncertainty, Greed– are getting people down.
Ambiguous times are the most dangerous for people.
Shut down and stop working. Change is literally pain. What to do?
Six Important Steps Innovation just doesn’t happen. But you can make it
come alive. Focus, Concentrate, Integrate.
MOTIVATION ABILITYPERSONAL 1. Make the Undesirable
Desirable2. Overinvest in skill
buildingSOCIAL 3. Harness peer pressure 4. Create social
supportSTRUCTURAL 5. Align rewards and
assure accountability6. Change the environment
Call It What You Will…
Incremental Innovation. Transformational Innovation or Business Model Redesign.
Or Just Plain “Significant Positive Change.”
The Times are a’ Changing. And we need to adapt.
Healthcare Innovation: Trends from the Trenches
Maybe Spaghetti is not a bad strategy. It could lead to some big ideas. We really don’t know what will work in the future
because the future is really being created by our own ideas and innovations.
Final Thoughts
Innovative ideas need a way to come out and be heard—try those Innovation Games.
The more ideas you have the more likely you will have good ones—we just don’t know which ones they are.
Once you have them, you have to nourish them, in a process that leads to effective implementation and cultural change.
Thanks To Our Sponsor: HIxD Healthcare Innovation by Design (HIxD) is a global network of healthcare
delivery and experience innovators. HIxD is the premiere resource for healthcare innovation knowledge, networking and career development. HIxD's 6800 members are executives, entrepreneurs, clinicians, designers, architects, engineers and IT professionals.
Join us tomorrow for another Webinar: Title: HIxD Pioneers Webinar: Innovation Games: How to "See, Feel and
Think" in New Ways Speaker: Andrea J. Simon, PhD Time: Fri, Oct 18, 2013 2:00 PM - 3:00 PM EDT Link: https://www3.gotomeeting.com/register/343864318
Next Webinar December 6th At Noon EST.
Reminder to join us for our next webinar on December 6th
Diane Auger, SVP of St. Vincent’s Medical Center in Bridgeport, CT.
Branding and Branding Innovations: What’s Happening?
Key questions: “Will Brands Matter? Will price commoditize care and drive consumer purchase patterns in new directions?”
Discussion And Questions
Share what you see as happening in “the trenches.” Take as many as we can now and we can continue
the discussion after the close of the webinar.
For More Conversation And Information
Andrea J. Simon PhDCorporate Anthropologist
President, Simon Associates Management [email protected]
Office 914-245-1641www.simonassociates.net
@simonandi
Kriss Barlow RN, MBA Principal
Barlow/[email protected]
www.barlowmccarthy.com
